Effectiveness of school-based nutrition education interventions to prevent and reduce excessive weight gain in children and adolescents: a systematic review.

OBJECTIVE: To evaluate the effectiveness of school-based nutrition education in reducing or preventing overweight and obesity in children and adolescents. SOURCES: Systematic search in 14 databases and five systematic reviews for randomized controlled trials conducted in schools to reduce or prevent overweight in children and adolescents. Body mass index and fruit and vegetable intake were used as primary and secondary measures of outcome, respectively. There was no restriction by date of publication or language, except for languages with structured logograms. We excluded studies on specific populations presenting eating disorders, dyslipidemia, diabetes, and physical or mental disabilities, as well as studies that used drugs or food supplements as components of the intervention. The assessment by title and abstract and the quality assessment were performed independently by two researchers. We used the Centre for Reviews and Dissemination's guidance for undertaking reviews in health care and the software EPPI-Reviewer 3. SUMMARY OF THE
FINDINGS: From the initially retrieved 4,809 references, 24 articles met the inclusion criteria. The extracted data show that there is evidence of positive effects on anthropometry and of increase in fruit and vegetable consumption. Characteristics of the interventions that demonstrated effectiveness are: duration > 1 year, introduction into the regular activities of the school, parental involvement, introduction of nutrition education into the regular curriculum, and provision of fruits and vegetables by school food services.
CONCLUSION: Interventions in schools to reduce overweight and obesity, as well as to increase fruits and vegetable consumption, have demonstrated effectiveness in the best-conducted studies.